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30.10.14

Better Care Fund boosted to £5.3bn to deploy 18,000 community workers

The Better Care Fund is to be boosted to £5.3bn a year to help join up health and social care services, the government announced last night.

The extra £1.5bn, on top of the original £3.8bn, is reportedly to come from more pooling of local budgets – it is not new money.

Local government secretary Eric Pickles and health secretary Jeremy Hunt made the announcement online last night and will be speaking about it at a conference today. They said the money will be invested in 151 plans across the country to help keep the elderly at home and healthy and avoid needless hospital and care home admissions. As part of the plan an extra 18,000 community workers will be “deployed” to provide care.

Hunt said that the plans are “the first step towards wholly integrated care” and added that it will lead to 160,000 fewer emergency stays in hospital, saving more than £500m a year.

Pickles said that the reason the government has introduced the Better Care Fund is that the current system for health and social care isn’t working any more.

304 Eric Pickles. c. DCLG crop 635502661369990000Writing in the Express he said: “We have an ageing population, and we need a new approach that provides the elderly with the care they need, the independence they want, and the dignity and respect they deserve.”

He went on to lay out how the new fund would transform care for the elderly.

“From next April elderly people will benefit from three major improvements,” Pickles wrote.

“First – Seven-day social care, which will mean they can expect the same level of care every day of the week, and don’t need to make unnecessary trips to hospital on the weekend.

“Second – They will have a single person that joins up services around their needs, so they don’t feel like they’re being passed from pillar to post before anything gets done.

“Third – information will be shared in a better and secure way between different services, so they don’t have to explain their problems again and again to lots of different people.”

He added: “The result will be a better quality care for the elderly, less strain on the NHS, and a better deal for the taxpayer.”

LGA chair David Sparks gave a mixed reaction to the plans.

He said: "While we recognise these reforms have the ability to change health and social care for the better, the government must fund councils properly to ensure this happens."

Hunt said that this marks the first step in changing the model of care of the health service, moving from a hospital focus to a community one - which mirrored his words to the Best Practice Show last week, previously reported by PSE.

Writing in the Telegraph today he said: “The first pillar of our plan is to change the basic NHS model from one centred on hospital care to one that helps people stay healthy and happy at home. Prevention is better than cure – not just for the patient, but for the NHS that picks up the tab when things go wrong.”

At Best Practice he went a step further, setting out his plan for how he sees the health service working closer together with local authorities on co-commissioning services.

FM8R8961“I’d like to see that go much further. I’d like to see CCGs clinically led becoming Accountable Care Organisations, responsible for all the care of the populations they look after,” he said. “Not just commissioning secondary care but with the Better Care Fund co-commissioning social care, with NHS England co-commissioning primary care and with local authorities co-commissioning public health. Because I think we have to join this up and we have to think about healthcare much more holistically that has happened in the past.

“One of the points in the NHS England Five Year Forward View was the very strong comments about doing more about obesity. We really need to link up the public health campaigns conducted by national and local government with the work done by GPs and practice nurses in GP surgeries. I think CCGs can be the spider in the centre of the web, working closely with lots of other people, and the Better Care Fund is a fantastic example of the way that kind of innovation is starting to happen.”

Responding to the Better Care Fund announcement, National Voices’ welcomed it as a step in the right direction, but also warned that it is only one of a number of efforts to encourage integration of health and social care and that these need to be co-ordinated.

Chief executive of the charity, Jeremy Taylor, said: “The Better Care Fund is a step in the right direction and there is lots of enthusiasm across the country to join up services. However, three things are now key to making this happen.

“We need to keep the emphasis on people, improving the quality and experience of care - we mustn’t let the current focus on saving money and reducing hospital admissions detract from this.

“Local areas need support to get involvement right. The best local plans involve not just doctors and nurses but people who use services, family, carers, friends, volunteers and charities and community groups. There are some great examples of this but they are far from the norm. 

“Finally, the Better Care Fund is just one of a number of national efforts encouraging integration of health and social care services and we worry that energy and money are being dissipated among too many initiatives: the Government and its national partners need to coordinate their own efforts to coordinate services.”

(Image of Eric Pickles c. DCLG)

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